High-frequency partial liquid ventilation in respiratory distress syndrome: hemodynamics and gas exchange.
Partial liquid ventilation using conventional ventilatory schemes improves lung function in animal models of respiratory failure. We examined the feasibility of high-frequency partial liquid ventilation in the preterm lamb with respiratory distress syndrome and evaluated its effect on pulmonary and systemic hemodynamics. Seventeen lambs were studied in three groups: high-frequency gas ventilation (Gas group), high-frequency partial liquid ventilation (Liquid group), and high-frequency partial liquid ventilation with hypoxia-hypercarbia (Liquid-Hypoxia group). High-frequency partial liquid ventilation increased oxygenation compared with high-frequency gas ventilation over 5 h (arterial oxygen tension 253 +/- 21.3 vs. 17 +/- 1.8 Torr; P < 0.001). Pulmonary vascular resistance decreased 78% (P < 0.001), pulmonary blood flow increased fivefold (P < 0.001), and aortic pressure was maintained (P < 0.01) in the Liquid group, in contrast to progressive hypoxemia, hypercarbia, and shock in the Gas group. Central venous pressure did not change. The Liquid-Hypoxia group was similar to the Gas group. We conclude that high-frequency partial liquid ventilation improves gas exchange and stabilizes pulmonary and systemic hemodynamics compared with high-frequency gas ventilation. The stabilization appears to be due in large part to improvement in gas exchange.
Sukumar
M
M
Division of Neonatology, Children's Hospital of Buffalo, State University of New York 14222, USA.
Bommaraju
M
M
Fisher
J E
JE
Morin
F C
FC
Papo
M C
MC
Fuhrman
B P
BP
Hernan
L J
LJ
Leach
C L
CL
D000818:Animals; D000831:Animals, Newborn; D005865:Gestational Age; D006439:Hemodynamics / Q000502:physiology*; D006611:High-Frequency Jet Ventilation; D006612:High-Frequency Ventilation; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000473:pathology / Q000503:physiopathology; D010100:Oxygen / Q000097:blood; D011652:Pulmonary Circulation / Q000502:physiology; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D012127:Respiratory Distress Syndrome, Newborn / Q000473:pathology / Q000503:physiopathology*; D012756:Sheep; D014655:Vascular Resistance / Q000502:physiology
D010100:Oxygen